Biological glues

Biological glues have actually been around and in use for many years now. To-date, the most common biological glue used in surgery is probably Tisseel. This is obtained from pooled human plasma (from large numbers of donors), and the Fibrin part of the blood is extracted, which is the sticky part of what makes up a blood clot. When mixed with donor Thrombin and Calcium, a sticky gel is formed that can be used as a glue and/or a sealant. There were a number of issues with these glues, which made them less than ideal:

– the ‘glue’ comes from pooled human plasma, which comes from multiple donors, which means that there is a very small potential risk of disease transmission
– application of the ‘glue’ was difficult and often messy and suboptimal
– the ‘glues’ did not have particularly good mechanical characteristics, in terms of setting times and ‘stickiness’
– the ‘glues’ were inert, in that they did not promote tissue healing.

There is a new generation of ‘biological glue’ that is now available, which has been developed by a Danish company called Vivostat. This new ‘biological glue’ is called Vivostat Platelet-rich Fibrin (PRF).

Vivostat PRF is not the same as PRP (which is platelet-rich plasma), which is a liquid that some people inject to try and promote tissue healing. PRF is quite different….

Vivostat PRF is made by taking 120ml of the patient’s blood at the start of an operation. The blood is spun down in a special machine in theatre and the Fibrin portion is taken. The patient’s platelets are also extracted from the sample. The two are then added together to create the PRF, which is ready for use within about 20 to 30 minutes. The Vivostat PRF can then be applied to tissues using a special applicator pen, which allows precise placement of the ‘biological glue’ to the required tissue surfaces, even arthroscopically (through keyhole surgery). The Vivostat PRF sets within a fraction of a second and the ‘glue’ is then far stickier and has much better mechanical properties than previous generation of ‘biological glue’. Importantly, the glue also has a high concentration of platelets, which contain growth factors — the growth factors are slowly released, and these then promote tissue healing … and hence the ‘glue’ is also ‘bioactive’.

Mr Ian McDermott was the first knee surgeon in the UK to use Vivostat PRF, and he has now used it in over 100 clinical cases, for the following specific indications:

Mr McDermott states: “Vivostat PRF is yet another step forward in the development of better surgical reconstructive techniques with improved patient outcomes, and another important adjunct in the evolution of cutting-edge knee surgery. I’m honoured and proud to have been in a position to have had access to the very best kit and the best possible equipment and grafts, to allow me to develop the field of biological knee reconstruction in the UK. The next exciting step will be when we start adding stem cells to the biological glues, to help further enhance tissue healing and regeneration, and this is something that we’re currently working on in our practice with the appropriate regulatory authorities.”